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Understanding the Do Not Resuscitate Order

Advances in modern equipment have increased the importance of what is now known as “End of Life Decision Making.” Our wishes about how we would like to be treated in the event we are in a coma, unable to make decisions for ourselves, or terminally ill, need to be made carefully and with great understanding of the potential consequences. If you have recently had a loved one in the hospital, particularly an older person, you may have heard the expression “DNR.” DNR stands for “do not resuscitate.” It’s important to have a good understanding what this means or serious mistakes can occur. The best summary I have seen of a DNR was stated this way: “If I die, don’t bring me back with the electric shocks and, artificial respiration and a ventilator. But, don’t kill me.” Just because a person decides that their wishes are to be DNR doesn’t mean they want to die! It certainly doesn’t mean healthcare providers should not take good care of them. Many people decide that cardiopulmonary resuscitation, accomplished through chest compressions or shocks to the heart to restart it, or artificial ventilation and mechanically assisted breathing, are experiences they simply don’t wish to have. They may agree to a “DNR” in order to make it clear that they don’t want their life to be saved from a heart attack or a respiratory arrest through those intense treatments. But there is a long distance from being DNR and wanting to die. A person may want to live a long time, despite being DNR, and people are entitled to good care and careful attention from doctors, nurses, and hospitals to make sure they are not harmed, even if they are “DNR.” When you get into end-of-life decision life decision making for people who no longer wish to go on living, an entirely different set of questions arise. Then we talk about hospice care, the withdrawal of life-sustaining measures, and even assisted suicide. Those issues and decisions will be the subject of further blog posts later on. But for present purposes, it’s enough to learn this all important fact, that just because a person is DNR doesn’t mean they don’t want to live, and it doesn’t mean they aren’t supposed to be taken care of just as well as anybody else. If you have questions about end-of-life decision making, it makes sense to consult your doctor, and your lawyer, to make sure all the terms and issues are understood by you while you have time to think of things. That way, if, for whatever reason, you are not able to make the decision for yourself later on, you’ll at least have made the decision with sound advice while you were able to do so.    
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